后腹腔镜肾上腺节细胞神经瘤切除六例

Retroperitoneal laparoscopic adrenalectomy for the treatment of 6 cases adrenal ganglioneuroma

目的分析后腹腔镜肾上腺节细胞神经瘤切除术的手术方法及疗效。方法回顾性分析行后腹腔镜肾上腺细胞神经瘤切除6例患者的临床资料，其中男性4例，女性2例。年龄32—59岁，平均41．3岁。左侧2例，右侧4例。结果6例手术均在腹腔镜下完成，无中转开放。术中血压无剧烈波动，术后病理均证实为肾上腺节细胞神经瘤。肿瘤直径3．6—11．2cm，平均（5．9±2．1）cm；手术时间90—210min，平均120min；出血50-700ml，平均160ml。术后7．9d出院，术后均无严重并发症。随访4-32个月无复发。结论后腹腔镜肾上腺节细胞神经瘤切除术手术创伤小、出血少、术野清晰、对肠道干扰少、恢复快、并发症少，是肾上腺节细胞神经瘤理想的治疗方式。

Objective To evaluate the laparoscopic procedure and therapeutic efficacy of retroperitoneal laparoscopic surgery for the treatment of adrenal ganglioneuroma. Methods 6 patients [4 male and 2 female, 32 to 59 （mean 41.3） years old], underwent retroperitoneal laparoscopic resection of adrenal ganglioneuroma. In this group, 2 patients with left adrenal ganglioneuroma, 4 patients with right adrenal ganglioneuroma. Results All of the 6 cases was successfully performed uneventfully with retroperitoneal laparoscopic adrenalectomy. Pathologic studies confirmed there were 6 cases of adrenal ganglioneuroma. No case was transferred to open operation. The blood pressure remained stable during operation. Mean tumor size was （5.9_＋2.1） cm （tumor diameter 3.6-11.2 cm） Mean operative time was 120（90-210） min. Mean estimated blood loss was 160 （50-700） ml. Postoperative hospital stay ranged from 7 to 9 days. All the patients were cured without relapse during 4-32 month, follow-up. Conclusions Retroperitoneal laparoscopic procedures for adrenal ganglioneuroma causes less traumatic; less operative blood loss; distinct image during operation; less postoperative discomfort; faster postoperative recovery and earlier return to daily activities and diet. Retroperitoneal laparoscopic procedure should be considered as the first choice for adrenal ganglioneuroma.